Presentation
A 40-year-old man with HIV presented to the emergency department (ED) with a headache. He stated that he has been off his medications for approximately 9 months because he recently felt better and decided to stop. He presented with complaints of intermittent headaches for the past month prior to admission, along with a 3-day history of fever and chills, watery diarrhea and depressed mood. The patient had a temperature of 102.6ºF in the ED. A lumbar puncture was ordered. His spinal fluid results showed high opening pressure, elevated protein and low glucose. His Gram stain revealed spherical organisms too large to be bacteria. Cultures revealed growth on blood and chocolate plates, but no growth on the MacConkey. Due to the Gram stain result, a Sabouraud Dextrose plate also set up. What was likely causing his headaches?
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Author Information
Kimberly Starr, Ph.D., D(ABMM), Assistant Director of Microbiology, FirstHealth of the Carolinas, Moore Regional Hospital
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